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目的用MR评价2型糖尿病(T2D)病人肝脏脂肪沉积的非均质性。方法收集121例T2D病人,以1H-MRS检查结果作为参考标准。肝脏脂肪变性定义为肝脏脂肪含量(LFC)≥5.56%。三回波梯度回波序列做T1恢复和T2*衰减的校正,用于计算左右半肝及肝段的LFC。用线性混合模型进行分析。结果 59例(48.8%)病人有肝脏脂肪变性,62例(51.2%)没有肝脏脂肪变性。左半肝脂肪变性比右半肝大(P<0.0001)[平均差为1.32%(范围:0.01%～8.75%)]。7例(5.8%)病人一侧LFC<5.56%,而另一侧LFC≥5.56%。在肝段水平左、右半肝的脂肪变性是非均质的,非脂肪变性病人分别为P<0.001、P<0.0001,脂肪变性病人分别为P<0.0001、P=0.0002[最大平均差为3.98%(范围:0.74%～19.32%)]。23例(19%)病人一个肝段LFC<5.56%,然而在至少一个其他肝段LFC≥5.56%。结论总的说来,肝段或叶脂肪变性的平均变异性低。然而,段的变异性有时能导致误诊。
Objective To evaluate the heterogeneity of hepatic fat deposition in patients with type 2 diabetes (T2D) using MR. Methods Totally 121 patients with T2D were collected. The results of 1H-MRS were used as the reference standard. Liver steatosis is defined as liver fat content (LFC) ≥ 5.56%. Three echo gradient echo sequence to do T1 recovery and T2 * attenuation correction, used to calculate left and right hepatic and liver LFC. Analyze with linear mixed model. Results Fifty-nine (48.8%) patients had hepatic steatosis and 62 (51.2%) had no hepatic steatosis. The left hepatic steatosis was greater than the right hepatic stelta (P <0.0001) [mean difference 1.32% (range: 0.01% -8.75%)]. Seven patients (5.8%) had a LFC of 5.56% on one side and a LCR of 5.56% on the other side. Steatosis at the level of the left and right halves of the liver was heterogeneous, P <0.001, P <0.0001 for patients with steatosis, P <0.0001, P = 0.0002, respectively, for patients with steatosis [maximum difference of 3.98% (Range: 0.74% ~ 19.32%)]. Twenty-three (19%) patients had a LFC of 5.56% in one liver segment, while LFC was ≥ 5.56% in at least one other liver segment. Conclusions In general, the average variability of steatosis in the liver segments or leaves is low. However, the variability of the segment can sometimes lead to misdiagnosis.